Diagnosing, managing and preventing anaphylaxis: Systematic review
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Diagnosing, managing and preventing anaphylaxis : Systematic review. / de Silva, Debra; Singh, Chris; Muraro, Antonella; Worm, Margitta; Alviani, Cherry; Cardona, Victoria; DunnGlvin, Audrey; Garvey, Lene Heise; Riggioni, Carmen; Angier, Elizabeth; Arasi, Stefania; Bellou, Abdelouahab; Beyer, Kirsten; Bijlhout, Diola; Bilo, M. Beatrice; Brockow, Knut; Fernandez-Rivas, Montserrat; Halken, Susanne; Jensen, Britt; Khaleva, Ekaterina; Michaelis, Louise J.; Oude Elberink, Hanneke; Regent, Lynne; Sanchez, Angel; Vlieg-Boerstra, Berber; Roberts, Graham; European Acad Allergy; Clinical Immunology Food Allergy.
I: Allergy, Bind 76, Nr. 5, 2021, s. 1493-1506.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Diagnosing, managing and preventing anaphylaxis
T2 - Systematic review
AU - de Silva, Debra
AU - Singh, Chris
AU - Muraro, Antonella
AU - Worm, Margitta
AU - Alviani, Cherry
AU - Cardona, Victoria
AU - DunnGlvin, Audrey
AU - Garvey, Lene Heise
AU - Riggioni, Carmen
AU - Angier, Elizabeth
AU - Arasi, Stefania
AU - Bellou, Abdelouahab
AU - Beyer, Kirsten
AU - Bijlhout, Diola
AU - Bilo, M. Beatrice
AU - Brockow, Knut
AU - Fernandez-Rivas, Montserrat
AU - Halken, Susanne
AU - Jensen, Britt
AU - Khaleva, Ekaterina
AU - Michaelis, Louise J.
AU - Oude Elberink, Hanneke
AU - Regent, Lynne
AU - Sanchez, Angel
AU - Vlieg-Boerstra, Berber
AU - Roberts, Graham
AU - European Acad Allergy
AU - Clinical Immunology Food Allergy
PY - 2021
Y1 - 2021
N2 - Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
AB - Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
KW - adrenaline
KW - anaphylaxis
KW - diagnosis
KW - epinephrine
KW - management
KW - prevention
KW - ACUTE ADVERSE-REACTIONS
KW - EPINEPHRINE AUTOINJECTOR
KW - FOOD-ALLERGY
KW - PEDIATRIC ANAPHYLAXIS
KW - AUTO-INJECTORS
KW - DOUBLE-BLIND
KW - MANAGEMENT
KW - RISK
KW - ADRENALINE
KW - CHILDREN
U2 - 10.1111/all.14580
DO - 10.1111/all.14580
M3 - Journal article
C2 - 32880997
VL - 76
SP - 1493
EP - 1506
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
SN - 0105-4538
IS - 5
ER -
ID: 249907440